Get Help

If you are a Georgia resident in need of items for your child and would like to request help from Kid Wellness Inc., please complete the form below.

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First Name *

Last Name *

Existing or Expecting Mom? *

I'm already a mom
I'm an expecting mom

Due Date? (Must be at least 6 months pregnant)

Are you currently employed? *

Monthly Income? *

How many children are in your household? (Include any unborn). *

Does anyone in your household receive Medicaid or SNAP benefits? *

Medicaid
SNAP
Both
Neither

At Kid Wellness Inc. we strive to help those in need by supplying essentials for mothers and their children. However some of our larger items are in high demand so you could potentially be placed on a waiting list as these items become available. Please select an item you need the most.

If applicable, what brand formula do you prefer?

Diaper/Pull Up Size? (Please specify).

We provide clothing sizes from Newborn to (Kids) 16 as well as maternity sizes. Please list the GENDER and current CLOTHING SIZE of your child(ren) below. Enter only one size per child. If you are requesting maternity clothes, please specify.

Example: Girl 12 Months, Boy 5T

We understand asking for help can be difficult. What made you reach out to us for assistance, and what are you seeking for you and your family? Please share your story below (All information will be kept confidential). *

We require submission of a valid Georgia ID. Will you be able to provide one upon request? *

Our mission is to empower underprivileged mothers and children by providing them with the support, resources, and opportunities they need to thrive.

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